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Home My WebLink About12831 (14)CITY OF DIAMOND BAR �� N DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES W 21660 E. Copley Drive Suite 190 (909)960-3195 Fax(909)861-3117 PRESS '+ BUILDING PERMIT APPLICATION FIRMLY JOBSITE ADDRESS APN LOT T T OWNER ADD S- CI ZI LLILL. APPLICANT CONTRACTO ADDRE CITY Z TEL. ARCH/E DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LF CENSE LAW FORTHE FOLLOWING REASON (SEC. 7031,6 BUSINESSAND PROFESSIONS CODE. ANY CITYOR COUNTYMMICH REMAESA PERMRTO WNSTRUCT,ALTER, IMPROVE, DEMOLISH,OR REPAIRANY STRUC. TURF. PRIOR TO ITS ISSUANCE. ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO RLE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW (CHAPTER 9 (COMMENCING WITH SECTION 70001 OF DIVISION 3 OF THE BUSINESS AND PRO- FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION. ANY VIOLATION OF SECTION 7031.6 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS ($SOD) J: D I, AS OWNEROFTHE PROPEUX OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSI- NESS AND PROFESSIONS NODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY 70 AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORKHa1SELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR TO OFFERED RSALE IF, TOW EVERTHE BUILDING OR IMPROVEMENT 6 SOLD WITHIN ONE YEAROF OOMPLE- TION, THE OWNER•BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). D L AS OWNER OF THE PROPERTY, AM EXCLUSNELYCONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI. CENSE LAW DOES NOT APPLYTOAN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WMOCONTRACTSFOR SUCH PROJECTS WITHACONTRACTOR(S) LICENSED PURSUANT TO THE CONTRAC- TORS LICENSE LAW). . O I AM EXEMPT UNDER SEC. B. 6 P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER 0(COMMENCNG WITH SECTION 7000) OF DIVISION 3 O THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE�ISINFULLCE AND EFFECT.LICENS LIC. NO. qq DATE CONTRACTOR WORKERS' COMPENSATION DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I HAVE AND WALL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, AS PROVIDED BY BECKON 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, 1 HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED aY SECTION 5700 OF THE LIBOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 15 ISSUED. MY WORKER ' y PENSATION INSURANC IE.R AND POLICY NUMBER ARE: CARRIER ■ L^/ Pa -A •7 POLICY NUMBER PHIS SECTMNEEDNOTBEOCMP ETEDOFTHEPETMT6RORONEHAOREDCDWARS(POD)ORUESS). 1 CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 37W OF THE LABOR CODE. RTTMWITH COMPLY WITH THOSE PROVISIONS. %�� DATE: L-� APPLICANT A<zwj .1= fr'�'I(Sze, WARNINO: FAILURE TO SECURE WORKERWOOMPENSATION COVERAGE IS UNLAWFUL. AND SHALL BE SUBJECT AM EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (8100.000). N ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 5701 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I HEREBYAFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (BEC. 3097, CN. C.). LENDERS NAME LENDER'S ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. P E N E RINUn lNONATUR ERMIITEE DATE APPLICATION 4 2 •- ��j PERMIT� P/C GATE 1 l NUMBER # ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE Z_ NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREAIVALUATION SFR/ADD/REM U) GaragalCarport WPatiolDeck ILL Poouspa (3 Z Re -Roof OCommercial m Valuation ADJ.AREA OUANTITY DESCRIPTION FEE U LFy- L�l L� Z DID U QZ 2 U W CONSTRUCTION PLAN REVIEW LECTRIC UNG MECHANICAL 'iii?tl "I'SFEE SSUANCE - —' S -vEC9-1998 ENERGY P/C ENERGY PERMIT [��'TjT'I' nF J]IAMI�`"�+ `•: �' '' RETENTION FEE: 1RTM.T)TNC3r h, `_�r+,='•_ PRE -ALT FEE: TOTAL FEES 6 % COMMENTS RECPT. NO. PAID BY VALIDATION _ WHITE—Department Copy, YELLOW—Financia Copy, PINK—Assessor Copy, GOLDENROD -File CGpy, GREEN--"Icant's Copy CITY OF DIAMOND BAR INSPECTION RECORD ET BACK FLOOR JOIST ;.•- FTGS/FORMS/STEEL 7E FHA REQMTS ELECTRIC GROUND LOOR DUCT UNDER FLOOR-DUCT- GROUND PLUMBING GROUND UNDER FJ-QOB CONDUIT-. SLAB GRADE FIREPLACE FOUNDATION - -• - } TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM - . -- - - - - ROOF SHEATHING = = - 8 FT. BOND BEAM - FRAMING/VENTILIATION FINAL BOND BEAM ROOF COVER PRE -GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC -� • 1h�j ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION { OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. _ GAS AIR -TEST - I • FINAL ZONING FINAL CONST. - { FIRE DEPT. FINAL j FINAL HEATING HEALTH DEPT. FINAL FINALELECTRIC •Z DEV. FEES PAID FINAL PLUMBING ENERGY i COMMENTS , - SEPTIC TANK SIZE SEEP PIT/Ll SIZE J ��-